P103 School-Based Health Center Access, Reproductive Health Care, and Contraceptive Use Among Sexually Experienced High School Students

Tuesday, March 9, 2010
Pre-Function Lobby & Grand Ballroom D2/E (M4) (Omni Hotel)
Kathleen Ethier, PhD1, Christine De Rosa, PhD2, Patricia Dittus, PhD3, Penny Loosier, MA, MPH3, Emily Chung, MPH, CHES2, Esteban Martinez, BS2 and Peter Kerndt, MD, MPH4, 1National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, 2Project Connect, Health Research Association, Los Angeles, CA, 3Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 4STD Program, Los Angeles County Department of Public Health, Los Angeles, CA

Background: School-based health centers (SBHC) are a means to deliver reproductive health care services, including contraceptives, condoms and STD screening. Some factors may limit the resources available to provide such services; there is little data to indicate whether students with access to a SBHC are more likely to receive services.

Objectives: To compare receipt of reproductive health care, contraceptive use, and STD screening among sexually experienced adolescents with or without access to a SBHC.

Methods: Twelve urban California high schools selected from areas with high teen pregnancy and STD rates, half with SBHCs, participated in a study. Of students surveyed from participating schools (n=5,930), 44% indicated they had ever had intercourse and were included in these analyses.

Results: Access to a SBHC did not influence receipt of general reproductive health care for either males or females and did not influence contraceptive use, either hormonal or condoms, for males. For females, those with access to a SBHC had increased odds of having received pregnancy or disease prevention care (OR=1.42, 95% CI=1.13-1.79), having used hormonal contraceptives at last sex (OR= 1.71, 95% CI = 1.26-2.33) and were more likely to have ever been screened for an STD (OR= 1.85, 95% CI = 1.45-2.36). 

Conclusions: Access to an on-site clinic in high schools is related to receipt of specific types of reproductive health care and use of hormonal contraceptives among sexually active females. Of concern, however, is a generally low rate of receipt of services even for those students with access as well as little impact of availability on care received by males.

Implications for Programs, Policy, and/or Research: Efforts to increase emphasis on SBHCs as a source of care needs to ensure that access to reproductive health care remains a priority. Other efforts to increase access and utilization of services in a variety of settings is necessary.

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